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The nation has been presented with a showpiece: the structural reform of the social and healthcare services. The creation process has been described as a real mess by many, while some have gone as far as calling it a melee. As soon as the new legislation has been passed, its implementation will kick off and the guilty can be rewarded and the innocent punished.

There has, however, been a general consensus on the basics: the reform is necessary. People have agreed unanimously that because of their small population sizes, many municipalities are unable to organise their services in an efficient manner. We have all seen it necessary to knock down bureaucratic boundaries horizontally as well as vertically, and we all have concerns over the erosion of primary healthcare.

But if there is such a wide-spread consensus, why is it so difficult to find solutions? What are the stumbling blocks stopping us from reaching decisions?

There are ideological stumbling blocks, which are related to the roles of the public and private sectors in service production. Many had hoped that the reform would open the doors for more extensive competition in social and healthcare services, which led to a great sense of disappointment when the majority of the parliamentary steering group was not willing to rely on market-driven provision of services, preferring to retain the strong and primary role of the public sector.

Political stumbling blocks are rooted in questions of power. The social and healthcare systems in municipalities and joint municipal authorities wield considerable economic, professional and especially political power. That is why radical changes to the foundations of the system are bound to be met with vocal opposition.

The main stumbling block, however, has been structural: many wanted to use the social welfare and healthcare reform to ease the way for a municipal reform to streamline local governance. Government negotiations led to an agreement under which the social welfare and healthcare system would be built around strong municipalities. But municipalities that would have large enough populations in respect to healthcare and social services remained a pipe dream when the government would not allow forced municipal mergers.

Thanks to this, the process stalled for two years, while the political fray raged over the superiority of the reform models, even though there were only minor differences between them. Soon it looked as if we were going to have a real disaster on our hands.

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